Diabetes & Covid-19: risks and measures against it

Updated: May 4

Here at DUET diabetes, we have been following the coronavirus outbreak closely. As the momentum continues to grow, we wanted to help you understand what the risk is for people living with diabetes and how we can be best prepared.

It has been more than 4 months since the World Health Organisation (WHO) first reported Coronavirus (COVID-19) on December 31st 2019 in Wuhan, China. In this time, the virus has spread at an alarming rate and has now become a global pandemic. We have all heard the news and read the papers on the importance of transparency in dealing with the virus, so based on this philosophy, we want to outline some facts relating to diabetes.

Are people living with diabetes at a higher risk?

Coronavirus can affect anyone, but according to the Scientific Advisory Group for Emergencies (SAGE) and WHO some people appear to be at a higher risk of developing the virus. These include older adults and people living with serious, chronic medial conditions such as cardiovascular conditions (heart disease), diabetes, kidney conditions, and lung disease such as COPD.

Professor Chris Whitty, the Government’s Chief Medical Advisor and Epidemiologist explained on BBC News: “the lungs are the common risk factor because the Coronavirus causes an infection of the lungs, and when this happens the airspaces fill up with fluid caused by inflammation, which makes the heart work harder. He adds “patients with diabetes often have complications involving the heart, but also the kidneys, and in the same way any strain on the body from infection can cause secondary problems in those organs.”

The leading UK Diabetes charity, Diabetes UK, further states, “When you have diabetes being ill can make your blood sugar go all over the place. Your body tries to fight the illness by releasing stored glucose (sugar) into your blood stream to give you energy. But your body cannot produce insulin to cope with this, so your blood sugars rise.

Your body is working overtime to fight the illness, making it harder to manage your diabetes. This means you’re more at risk of having serious blood sugar highs and lows, as well as longer-term problems with your eyes, feet and other areas of your body. This is why individuals with consistently high blood glucose levels are particularly at higher risk.

However, if you are generally in good health and stay in top of your diabetes management, the risk is similar to someone without diabetes.”

So, it appears that there could be a silver lining!

What steps can you take for prevention?

There is currently no vaccine to prevent the coronavirus, however trials have recently begun to assess the safety and effectiveness in this country of a proposed vaccine. Research into the development of a vaccine against this new virus and treatments for Covid-19 is taking place globally and as more is being learnt about this virus we are constantly being updated. The following guidelines have been issued by the Government, The IDDT (The Independent Diabetes Trust) and Diabetes UK:

The primary method of prevention is to wash your hands frequently and thoroughly, for a minimum of 20 seconds.

[graphic from www.bbc.co.uk]

In addition, the InDependent Diabetes Trust (IDDT) urges those living with diabetes, to review how they manage their time in isolation. It is important to keep your immune system in good shape and not to overlook everyday habits such as:

Take your prescribed medication as instructed (if you become unwell you may be told to alter doses or temporarily stop certain medications).

We all have a responsibility, during this time, to follow the advice that has been given to us. By managing your diabetes, you are reducing the need for medical attention, protecting the NHS and ultimately, saving lives.

As a reminder, other protective measures released by SAGE and Public Health England:

Stay at home - no unnecessary journeys or social contact

Necessary journeys have been highlighted as the following:

Essential Food shopping

Medical Needs

Exercise once a day following social distancing rules (2 meters from any individual)

For a person living with diabetes, it is important that you take the infection seriously. The number one thing to do is:

isolate yourself and your family

STAY AT HOME FOR AT LEAST 7 DAYS IF YOU START SHOWING SYMPTOMS – If you feel that you cannot cope with your symptoms or if your illness gets worse, or your symptoms are no better after 7 days, use the online 111 coronavirus service https://111.nhs.uk/covid-19 in the first instance. If you do not have internet access, call NHS 111. If you are struggling with breathing, please seek emergency medical attention. For a medical emergency, dial 999.

You may need to stop taking some medications during the period you are unwell, however…

NEVER STOP INSULIN!

Seek medical attention if you are continuously vomiting, if you have persistently high or low blood glucose levels despite altering your medication, or (if testing) ketone levels are not reducing despite following sick day rules (see below for links).

More information regarding ‘sick day rules’ for people living with diabetes who become unwell with coronavirus is available via the following links (from the London Clinical Networks and shared by Partha Kar):

11.If you don’t check your blood glucose levels at home, be aware of the signs of hyperglycaemia (high blood glucose) which include:

Passing more urine than normal

Very thirsty

Tiredness, headaches and lethargy

PLEASE SEEK MEDICAL ADVICE IF YOU HAVE THESE SYMPTOMS

12.If you are using an insulin pump, a continuous glucose monitor or a flash glucose monitor (FreeStyle Libre) you will still be able to get these from your pharmacy. For those that use a blood glucose meter, Diabetes UK has negotiated with several companies to make certain test strips available through their online shop https://shop.diabetes.org.uk/

13.If you’re using insulin, you’ll need to know how to adjust your insulin doses to maintain healthy blood glucose levels. It is also a smart decision to get your refills arranged with your local pharmacy or arrange online repeat prescriptions via websites such as www.echo.co.uk or https://www.pharmacy2u.co.uk/ Prescriptions can be delivered to your home for free with some of these services. Please check on individual sites.

14.Check with your doctor to see if they can provide virtual consultations or other digital check-ins.

15.If you are already having treatment for a foot or eye problem, and you don’t have coronavirus symptoms, check with your clinic/hospital to see if the appointment is still going ahead. They will be able to offer advice.

17.If you spot something new that you’re concerned about, like a cut on your foot, contact your GP practice and explain the situation. If you can’t get through, call 111 for advice.

Miscellaneous support

There has always been a wealth of information and support available for people living with diabetes and recently there is an increasing amount being shared regarding Covid-19 and diabetes. As time goes by experts and researchers will learn more and advise accordingly. In the meantime, we would like to share some interesting, uplifting and entertaining resources:

Bulletins from Professor Partha Kar (the National Specialty Advisor for Diabetes at NHS England):

@_diabetes101 is a twitter account consisting of a group of healthcare professionals helping to signpost people with diabetes to accredited information and boost morale through fun interactions and challenges!

Looking towards the future of the virus

As we look towards the future, it is hard to predict what will happen. Regardless what happens, the important thing right now is to be vigilant in how we care for ourselves and ensure we take the necessary precautions to stay healthy.